Antidepressants vs. Exercise

Are you taking an antidepressant?  How about a medication for anxiety like Xanax or Klonipin?  These days, antidepressants are handed out like M&Ms, and most mothers seem to be taking something-prescribed or not.  Most of the time, antidepressants are prescribed by a general physician, internist, or OBGYN.  Sadly, few of these physicians have been trained to assess and diagnose anxiety and mood related problems at all.   

Recently, I came down with the “kiddie crud” and visited a local physician.  My daughter was off on her spring break, and I had looked forward to being outside together.  Unfortunately, I felt to ill to enjoy any of it.  I noticed two pharmaceutical reps leaving the office when I was in the waiting area, and I suspect that they were probably introducing him to the new “latest and greatest” antidepressant.

After meeting with me, he prescribed an antibiotic, a steroid, and a prescription for Claritin.  As I was leaving, I thanked him and jokingly said, “Gee, I’m glad I came in today-I wasn’t going to until I started getting a little short at home this morning.”  BIG MISTAKE.  The guy swiveled around in his chair so fast that I’m pretty sure he had a case of whiplash.  He looked me squarely in the eye and asked excitedly “Do you think you are depressed?”

The answer was and is no.  I’m not depressed, but I sure was feeling like shit.  I wanted to ask, “Did you know that I’m a clinical psychologist?”  Had I given any indication that I might, in fact, be depressed or sad, I am certain that I would have walked out with an antidepressant sample and a prescription for long term use.

Here is the problem with this common, yet careless approach to antidepressant prescription:  mood problems can exist for many different reasons.  Bipolar Type I or II, hypothyroidism, severe hormonal imbalance related to PMS or perimenopause, anxiety, or bereavement can all cause sadness and depression.  Medicating any of these problems will either make you much worse or prevent positive life changes and personal growth.

If you ARE, indeed, depressed, then you should see either a clinical or counseling psychologist or a psychiatrist.  The best approach to treating depression is said to be a combination of antidepressant medication and cognitive behavioral therapy, but we’re now learning that exercise may work just as well as both, if not better.  Antidepressant medication begins working at the bottom of the brain in the more primitive part that controls bodily functions, moving up towards the frontal lobe with time.  CBT begins working at the top of the brain within the frontal lobe and works in the opposite direction.  Exercise starts at both ends and works towards the middle.

Antidepressant meds work to increase serotonin levels (usually, though some work on other neurotransmitters) between the cells.  Exercise rebalances all of your mood related neurotransmitters, and this effect is immediate.  The increase in neurotransmitters happens in only the areas of the brain that need it, not everywhere (the reason for side effects with antidepressants).  Even better, exercise increases a chemical called BDNF, along with others, which is like Miracle Gro for the brain.  It helps grow new brain cells that we can fill with new information.  

Depression is known to shrink areas of the brain, and exercise reverses this shrinking and regenerates new brain cells in those areas. 

The best research comparing antidepressant medication and exercise as treatments for depression was conducted by Blumenthal at Duke University in 1999.  This landmark study found exercise to be equally as effective as Zoloft in treating depression. However, exercise obviously has no noxious side effects like decreased sex drive, weight gain, fatigue, and sleepiness (all the things that make you feel even more depressed).  

This study should be taught in medical school, doctor programs for clinical psychology, and all nursing home staffs.  Any patient prescribed with an antidepressant should be given this information, if not a copy of the study itself.  In fact, I believe that all patients prescribed with an antidepressant should probably be required to exercise.  Most patients never know this information, and I personally think this should be a form of medical malpractice.

I could write much, much more on the benefits of using exercise as a prescriptive treatment for depression, along with anxiety, addiction, and even learning disorders.  This post would be way too long, so I’ll save the rest for later.  For now, suffice to say that exercise is one of the very best treatments available for treating depression.  Am I against the use of antidepressants.  Not at all.  I’m for the use of antidepressants for those who need them, specifically to fill the gap in motivation and energy to help the person get moving again.  

That’s all for now, folks.  Get your exercise in every day, and think of it as medicine.  There is no better way to change your mood, your body, and your brain at once.  The way you cope with stress will determine the way that stress changes your brain.  Choose wisely.

Lisa Benton




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